An integrated telemanagement program based on an integrated health care model in patients with type 2 diabetes mellitus: A prospective study (Preprint)

Abstract

BACKGROUND The prevalence of type 2 diabetes, a lifelong progressive disease, is increasing every year, causing it to become a growing public health problem worldwide. Active self-management by patients can slow the development of diabetes and reduce the risk of complications. However, outside of the hospital, in the absence of monitoring by doctors, nurses, etc., patients' self-efficacy in diabetes management is low, and adherence is poor, which seriously affects the effectiveness of diabetes treatment. OBJECTIVE Objective: The objectives is to investigate the effectiveness of a remote integrated management program based on an integrated health care model in patients with type 2 diabetes mellitus (T2DM). METHODS Method: This study utilized its own pre- and postintervention research methodology. Data on sociodemographic characteristics, past disease history, self-management, and laboratory indicators were collected from the study subjects before the intervention. Then, a comprehensive management program (including medical nutrition, exercise, medication, self-monitoring of blood glucose, and health education) using an integrated health care model was used to provide a 3-month teleintervention for the study participants. The main outcome indicator was glycated hemoglobin level; other outcome indicators included self-management behavior, self-efficacy, quality of survival, the results of blood glucose, blood lipid, and urine tests and other indicators. All data were analyzed using SPSS software. RESULTS Results: A total of 101 study participants with a mean age of 48.46 ± 12.45 years were recruited for this study. The results of pre- and postintervention analyses and comparisons showed that glycated hemoglobin(HbA1c), fasting blood glucose (FBG), 2 h postprandial glucose (2-h PG), total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and body mass index (BMI) improved in the postintervention period compared with the preintervention period, and the differences were statistically significant (P < 0.05); the self-management behavior scale score, self-efficacy scale score, and quality of survival scale score improved in the postintervention period, and the differences were statistically significant (P < 0.05). CONCLUSIONS Conclusion: Remote integrated management program interventions based on an integrated health care model can improve health outcomes, increase glycemic compliance, and improve self-management behaviors, self-efficacy, and quality of survival in patients with T2DM. CLINICALTRIAL This study used a before-and-after controlled study design to provide an interventions for T2DM patients through a 3-month remote integrated management program based on a health care integration model, and assessed the changes in metabolic indices such as HbA1c levels, lipid levels, and self-management behaviors of patients before and after the intervention. The study was registered in the Chinese Clinical Trial Registry (registration no. ChiCTR2300077466).